I stumbled out into the cold winter afternoon, my head still spinning with fresh after-images of our latest patient—an old, thin lady with a porcelain-like frailness, barely conscious when we had lifted her down from the ambulance. Her jagged breaths, each one a strenuous testament of her will to live, continued to echo in my ears. The doctors had said little in front of us, but death, that dreaded inevitability, had hung forebodingly upon their silence. I felt sick. Nothing, not even the losses I had experienced in the past, could have readied me for this frank demonstration of mortality in the final moments of a stranger’s life.
I sank down onto the steps of the hospital as bitter shame, mingled with self-doubt, gushed forth within me. It had only been a few weeks since I had excitedly joined the Emergency Department (ED) volunteer team at Taipei Municipal Hospital* but now, listening to the distant sounds of homebound traffic, I suddenly just wanted to go home and never return to this miserable place again. “Oh you weak-hearted fool!” I berated myself. “How could you ever hope to care for others when you don’t even have the courage to confront their suffering?”
“Eat,” came my unexpected answer, and before I knew it, someone had stuffed a Snickers bar into my hand. The chocolate tasted bland in my mouth, but somehow, it calmed me, and the tempest in my head gradually subsided.
“Thanks, Sergeant,” I muttered gratefully, turning to face my benefactor, a large, burly man sporting a distinctive bowl cut and a tired pair of blue scrubs. His real name was Tim, but like everyone else in the hospital, I had grown accustomed to calling him by his nickname. Sergeant was a medical assistant in the ED, and since my first day at work, we had become fast friends, bonding over a shared interest in wildlife photography. His warlike moniker and imposing physical stature belied a gentle, delicate nature infused with a deep sense of compassion. His job, as he once described to me, was to do “everything to help the doctors and nurses do theirs.” This ranged from routinely addressing patient complaints and consoling grieving families to buying snacks for the elderly, who were often overlooked by the rest of the medical staff. He also took it upon himself to care for his colleagues, and during the winter, he regularly brought in hot beverages for the entire office—small, thoughtful acts like that here and there, he followed no plan other than the one in his heart.
His name was heard all over the ED every day, as the majority of patients preferred to call on him—rather than the busy physicians and nurses—for help, even though most of the time all he could offer them were some words of encouragement and a smile. But those words and smiles eased the pain of isolation created by illness in a way that painkillers and antibiotics never could, and most of the time, they were enough. Sitting here with his reassuring presence beside me and a half-finished chocolate bar in my hand, I finally understood a little of how his patients had felt, to have received a medicine beyond medicine.
“How do you do it?” I asked him quietly, “How can I overcome my weak-heartedness to be able to care for people like you do?”
He smiled. “By not giving up on who you are now. Even after so many years, I still feel the same way you do about suffering and death, but I don’t see it as a sign of weakness—a ‘weak heart’ is one that cares, and you shouldn’t sacrifice it for anything, not even for a career in medicine.”
A weak heart is one that cares. For the next few minutes, we sat in silence, watching the last rays of sunlight retreat from the cityscape.
“I’m ready to go back,” I announced after a while.
* The name of the hospital has been changed to protect confidentiality.
The Arnold P. Gold Foundation Humanism in Medicine Essay Contest
The Arnold P. Gold Foundation was founded in 1988 with the mission of maintaining the balance between medical science and human needs by ensuring that doctors value and provide patient-centered care that is both compassionate and cutting edge. The Gold Foundation’s annual Humanism in Medicine Essay Contest was launched in 1999 in order to allow medical students to reflect on their experiences through writing.
In 2012, participants were asked to reflect on the words of the Foundation’s founder, Dr. Arnold P. Gold: “You are now a steward of medicine and it is your job to safeguard the profession” What does it mean to you (and your patients) to be a steward of medicine? More than 200 students submitted essays which were reviewed by a distinguished panel of judges ranging from esteemed medical professionals to authors in the field of humanistic medical care.
The top three essays were selected along with ten honorable mentions. Winning essays were published on The Arnold P. Gold Foundation website (www.humanism-in-medicine.org) and will be published in consecutive Fall issues of Academic Medicine.